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opinion matters 9/30/05 12:39 Page 48
OPINION MATTERS
Country DM Status
Australia Over $400 million being spent on demonstration projects the driving decision has
been to build new expensive hospitals or to keep people out of them via DM – a new
DM association was formed
Germany DM legislated with reimbursement for sick funds that provide DM
Singapore National initiative initiated in 2000 – leveraging public sector infrastructure
United Several models in early testing. NHS Strategic Health Authorities developing RFP’s
Kingdom
South Africa Private sector programmes achieving good results; DM is being combined with
wellness programmes.
India Several pharma-backed DM pilots being tested
Spain Government initiated pilot being developed and tested in Barcelona
Brazil Favorable system. Free standing DMO and health plan models.
Argentina Private hospital initiatives with good use of technology/EMR
Japan Ministry of Health interest; private sector pilots; New DM Association, book,
newsletter
Netherlands Academia-driven assessment of DM programmes in progress; private and public
sector interest
Italy US company pilots being developed…early stages
Taiwan Pilot programmes in five disease states
Poland Physician-based model being developed and tested for “proof of concept”
Canada Calgary, Vancouver and Ontario are leading public adoption of disease management
Greece Unusually large private sector [47% of total healthcare expenditures]; expect private
sector pilots in late 2005/early 2006; pharma-centric models are likely
South Korea Pilot programmes initiated in 2004; no feedback to date
imagine or believe that they could. The United States DM
industry is beginning to become more aggressive in finding
ways to operationalize over 30 years of behaviour change
research. The next 2-3 years should produce interesting
results in this area.
Conclusion
A decade of United States DM experience has produced a
wealth of knowledge concerning how we can better manage
chronic disease. In the next decade, the expansion of DM
into the public sector and internationally will increase our
understanding of how to best address the chronic disease
crisis. More robust use of technology and the effective
operationalizing of behaviour change science will also
contribute considerable to better DM outcomes. Finally,
research into different models of DM and integration with
health management will lead to a greater benefit to
societies around the world. As disease management
expands globally the hospital community has the
opportunity to explore how DM can help establish
stronger relationships with their patients. ❑
Curriculum Vitae
Warren E Todd, MBA, author of the first
published book on disease management, has
pioneered the concept around the world for the
past decade as founding board member, past
President and Executive Director of the Disease
Management Association of America (DMAA) and
as the founder of the International Disease
Management Alliance (IDMA).
48 | World Hospitals and Health Services | Vol. 41 No. 3